Basic Information
| Provider Information | |||||||||
| NPI: | 1740458124 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DONALD | ||||||||
| FirstName: | TRAMECIER | ||||||||
| MiddleName: | JANUARY | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | COTA/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 608 E 4TH ST APT 7 | ||||||||
| Address2: | |||||||||
| City: | BAY MINETTE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 365073700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2517674020 | ||||||||
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| Practice Location | |||||||||
| Address1: | 300 FAULKNER DR | ||||||||
| Address2: | |||||||||
| City: | BAY MINETTE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 365072771 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2519379881 | ||||||||
| FaxNumber: | 2519379804 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/19/2008 | ||||||||
| LastUpdateDate: | 02/19/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | 2810 | AL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.